Influence of food and lifestyle on the risk of developing inflammatory bowel disease

BACKGROUND

The Barwon area in Australia has one of the highest incidence rates of inflammatory bowel disease (IBD) and therefore is an ideal location to study the impact of environmental exposures on the disease's development.

AIM

To study these exposures prior to the development of IBD in a population-based cohort.

METHOD

One hundred and thirty-two incident cases (81 Crohn disease (CD) and 51 ulcerative colitis (UC)) from an IBD registry and 104 controls replied to the International Organization of Inflammatory Bowel Diseases environmental questionnaire. This included 87 questions about pre-illness exposures that included childhood illnesses, vaccinations, breastfeeding, house amenities, pets and swimming, diet and smoking.

RESULTS

The factors associated with CD included smoking (odds ratio (OR): 1.42, confidence interval (CI): 1-2.02, P = 0.029); childhood events, including tonsillectomy (OR: 1.74, CI: 1.15-2.6, P = 0.003) and chicken pox infection (OR: 3.89, CI: 1.61-9.4, P = 0.005) and pre-diagnosis intake of frequent fast food (OR: 2.26, CI: 1.76-4.33, P = 0.003). In UC, the risk factors included smoking (OR: 1.39, CI: 1.1-1.92, P = 0.026) and pre-diagnosis intake of frequent fast food (OR: 2.91, CI: 1.54-5.58, P < 0.001), and high caffeine intake was protective (OR: 0.51, 95% CI: 0.3-0.87, P = 0.002). Other protective exposures for UC included high fruit intake (OR: 0.59, CI: 0.4-0.88, P = 0.003) and having pets as a child (OR: 0.36, CI: 0.2-0.79, P = 0.001).

CONCLUSION

This first Australian population-based study of environmental risk factors confirms that smoking, childhood immunological events and dietary factors play a role in IBD development; while high caffeine intake and pet ownership offer a protective effect.

Isolated language impairment as the primary presentation of sporadic Creutzfeldt Jakob Disease

OBJECTIVES

Sporadic Creutzfeldt Jakob Disease (sCJD) is a neurodegenerative disorder that typically presents as a rapidly progressive encephalopathy associated with various neurological features, culminating in akinetic mutism and death. Atypical cases, presenting with an isolated focal may cause diagnostic confusion. We described a series of patients with sCJD presenting with isolated language impairment.

MATERIALS & METHODS

We report a patient with sCJD referred to the NCJDRSU, who presented with isolated language impairment and subsequently identified all cases of sporadic CJD on the NCJDRSU database (covering the years 1990-2012) with an isolated language impairment presentation.

RESULTS

Nineteen patients (11 females) with sCJD (1.19% of all patients) had an isolated language disorder of at least 2 weeks duration as the first neurological symptom pattern. Mean age at onset was 68.28 years. No specific pattern of language affection was seen in these patients. Further progression usually affected more than one neurological domain, with all patients eventually developing cognitive decline and myoclonic jerks. The median duration of illness was 4 months. CSF 14.3.3 was positive and S100b level was elevated in all patients in whom it was performed. EEG and MRI showed typical features of sCJD in six patients each. Most patients showed MM genotype of PRNP codon 129.

CONCLUSION

This study highlights the fact that isolated aphasia can be the first neurological symptom approximately in 1% of patients with sCJD. The diagnosis is usually made with appearance of other clinical features and investigation results, but in a small minority, these may not be apparent for relatively long periods.

Erosion/Oxidation Resistant Coatings for High Temperature Polymer Composites

Thermally sprayed coatings are being studied and developed as methods of enabling lightweight composites to be used more extensively as structural components in propulsion applications in order to reduce costs and improve efficiency through weight reductions. The primary goal of this work is the development of functionally graded material (FGM) polymer/metal matrix composite coatings to provide improved erosion/oxidation resistance to polyimide-based polymer matrix composite (PMC) substrates. The goal is to grade the coating composition from pure polyimide, similar to the PMC substrate matrix on one side, to 100% WC-Co on the other. Both step-wise and continuous gradation of the WC-Co loading in these coatings are being investigated. Details of the processing parameter development are presented, specifically the high velocity oxy-fuel (HVOF) combustion spraying of pure PMR-II matrix material and layers of various composition PMR-II/WC-Co blends onto steel and PMR-15 composite substrates. Results of the HVOF process optimization, microstructural characterization, and analysis will be presented. The sprayed coatings were evaluated using standard metallographic techniques - optical and scanning electron microscopy (SEM). An SEM + electron dispersive spectroscopy (EDS) technique has also been used to confirm retention of the PMR-II component.

Electrical Resistivity Imaging of Seawater Intrusion into the Monterey Bay Aquifer System

We use electrical resistivity tomography to obtain a 6.8-km electrical resistivity image to a depth of approximately 150 m.b.s.l. along the coast of Monterey Bay. The resulting image is used to determine the subsurface distribution of saltwater- and freshwater-saturated sediments and the geologic controls on fluid distributions in the region. Data acquisition took place over two field seasons in 2011 and 2012. To maximize our ability to image both vertical and horizontal variations in the subsurface, a combination of dipole-dipole, Wenner, Wenner-gamma, and gradient measurements were made, resulting in a large final dataset of approximately 139,000 data points. The resulting resistivity section extends to a depth of 150 m.b.s.l., and is used, in conjunction with the gamma logs from four coastal monitoring wells to identify four dominant lithologic units. From these data, we are able to infer the existence of a contiguous clay layer in the southern portion of our transect, which prevents downward migration of the saltwater observed in the upper 25 m of the subsurface to the underlying freshwater aquifer. The saltwater and brackish water in the northern portion of the transect introduce the potential for seawater intrusion into the hydraulically connected freshwater aquifer to the south, not just from the ocean, but also laterally from north to south.

Effect of subcutaneous insulin detemir on glucose flux, lipolysis and electroencephalography in type 1 diabetes

The aim of the present study was to investigate the effects of subcutaneous detemir on glucose flux, lipid metabolism and brain function. Twelve people with type 1 diabetes received, in random order, 0.5 units/kg body weight detemir or NPH insulin. Glucose concentration was clamped at 5 mmol/l then increased to 10 mmol/l. Glucose production rate (glucose Ra), glucose uptake (glucose Rd) and glycerol production (glycerol Ra) were measured with a constant intravenous infusion of [6,6(2) H(2)]glucose and [(2)H(5)]glycerol. Electroencephalography direct current (DC) and alternating current (AC) potentials were measured. While detemir induced similar effects on glucose Ra, glucose Rd and glycerol Ra during euglycaemia compared with NPH, it triggered a distinct negative shift in DC potentials, with a significant treatment effect in frontal cerebrocortical channels (p < 0.001). AC spectral power showed significant differences in theta and alpha frequencies during euglycaemia (p = 0.03). Subcutaneous detemir exerts different effects on brain function when compared with NPH in people with type 1 diabetes. This may be an important mechanism behind the limitation of weight gain with detemir.

Caffeine consumption does not have an effect on digital microvascular perfusion assessed by laser Doppler imaging on healthy volunteers: a pilot study

Caffeine is one of the most commonly consumed pharmacologically active ingredients in the Western world. It is postulated to cause peripheral vasoconstriction and decreased digital blood flow. As a result, many hand surgeons forbid caffeine consumption post-operatively by patients undergoing replantation surgery for fear of compromising healing. We hypothesized that caffeine has no effect on digital microvascular perfusion. Healthy volunteers were recruited and digital microperfusion was assessed using laser Doppler probes attached to the finger pulp, both before and after ingestion of 100 mg of caffeine. A total of 34 patients were included in the final study. The mean flow before the consumption of caffeine was 226.15 PU. The mean flow following the consumption of caffeine was 197.7 PU. This decrease was not statistically significant. This study revealed no decrease in digital blood flow following the ingestion of 100 mg of caffeine by healthy volunteers, as measured by laser Doppler flow monitoring.

LEVEL OF EVIDENCE

3.

Bootstrap calibration and uncertainty estimation of downhole NMR hydraulic conductivity estimates in an unconsolidated aquifer

Characterization of hydraulic conductivity (K) in aquifers is critical for evaluation, management, and remediation of groundwater resources. While estimates of K have been traditionally obtained using hydraulic tests over discrete intervals in wells, geophysical measurements are emerging as an alternative way to estimate this parameter. Nuclear magnetic resonance (NMR) logging, a technology once largely applied to characterization of deep consolidated rock petroleum reservoirs, is beginning to see use in near-surface unconsolidated aquifers. Using a well-known rock physics relationship-the Schlumberger Doll Research (SDR) equation--K and porosity can be estimated from NMR water content and relaxation time. Calibration of SDR parameters is necessary for this transformation because NMR relaxation properties are, in part, a function of magnetic mineralization and pore space geometry, which are locally variable quantities. Here, we present a statistically based method for calibrating SDR parameters that establishes a range for the estimated parameters and simultaneously estimates the uncertainty of the resulting K values. We used co-located logging NMR and direct K measurements in an unconsolidated fluvial aquifer in Lawrence, Kansas, USA to demonstrate that K can be estimated using logging NMR to a similar level of uncertainty as with traditional direct hydraulic measurements in unconsolidated sediments under field conditions. Results of this study provide a benchmark for future calibrations of NMR to obtain K in unconsolidated sediments and suggest a method for evaluating uncertainty in both K and SDR parameter values.